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- Title
Subtype Distribution, Clinical Features, and Survival in B-cell Chronic Lymphoproliferative Disorders in China: A Review of 1592 Cases.
- Authors
Yan, Yuting; Lv, Rui; Xiong, Wenjie; Li, Zengjun; Wang, Yi; Yu, Ying; Yu, Zhen; Wang, Tingyu; Sui, Weiwei; Liu, Wei; Zou, Dehui; Yi, Shuhua; Qiu, Lugui
- Abstract
<bold>Background: </bold>B-cell chronic lymphoproliferative disorders (B-CLPDs) are characterized by the sustained accumulation of monoclonal B cells. Limited studies have systematically described the clinical features and outcomes of the whole patient group, especially in Eastern populations.<bold>Patients and Methods: </bold>A total of 1592 patients with newly diagnosed B-CLPD were enrolled. Chronic lymphocytic leukemia (CLL) accounted for 39%, and Waldenström macroglobulinemia (WM), leukemic marginal zone lymphoma, follicular lymphoma (FL), and mantle cell lymphoma (MCL) constituted 13%, 13%, 9%, and 8% of cases, respectively.<bold>Results: </bold>The median age at diagnosis was 58 years, and the male/female ratio was 1.8:1. The 17p and 11q deletions were most common in MCL (36% and 17%, respectively), and 13q deletion and trisomy 12 were most frequent in CLL (35% and 21%, respectively). Patients with leukemic MCL had significantly worse survival than that of patients with other disease entities, with a 3-year overall survival (OS) of 58%, followed by 68.2% for WM/lymphoplasmacytic lymphoma. Those with CLL, leukemic marginal zone lymphoma, and FL had relatively favorable outcomes, with a 5-year OS > 80%. The survival of patients with B-CLPDs has improved over time with the emergence of novel drugs (3-year OS improvement from 82.1% to 92.2%). The improvement in survival mainly resulted from improvement among patients with MCL, WM/lymphoplasmacytic lymphoma, and FL. On multivariate analysis, only hemoglobin, lactate dehydrogenase, and 17p deletion were independently associated with survival (hazard ratio, 1.6, 2.0, and 3.1, respectively).<bold>Conclusions: </bold>Comprehensive analysis of the clinical characteristics, immunophenotypic profiles, and cytogenetic features can be helpful in the differential diagnosis, especially for patients without a non-bone marrow biopsy specimen available. Universal prognostic factors could help with the early detection of high-risk patients and stratification for risk-adapted therapy.
- Subjects
CHINA; CHROMOSOMES; SURVIVAL; RESEARCH; GENETIC mutation; B cells; CHRONIC diseases; RESEARCH methodology; PROGNOSIS; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; LYMPHOPROLIFERATIVE disorders
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2020, Vol 20, Issue 6, pe270
- ISSN
2152-2650
- Publication type
journal article
- DOI
10.1016/j.clml.2019.11.002